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Contact Information

CIBOLA GENERAL HOSPITAL PHCY
1016 E ROOSEVELT AVE
GRANTS, NM87020-2118
 Phone: 505-287-5320
 Fax: 505-287-5325
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CIBOLA GENERAL HOSPITAL PHCY

NPI Number 1093024275
LBN Legal business name CIBOLA GENERAL HOSPITAL PHCY
Authorized official ANDREW HALL - (DIRECTOR OF PHARMACY)
Entity Organization
Organization subpart 1 No
Enumeration date 10/05/2010
Last updated 10/05/2010 - About 16 years ago
Identifiers
NM License # PH00002150
NM Medicaid 00729
Other 3204625 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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